Vitiligo

Vitiligo disease

        Vitiligo concerns both men and women and vitiligo affects about 1% of the population. Vitiligo is a chronic disease of the skin characterized by the appearance of white spots of a specific contour mat on the feet, hands, face, lips or other body parts. These spots are depigmented because the cells responsible for pigmentation, melanocytes, are destroyed. Doctors do not fully understand the origin of vitiligo, but they suspect among other things, an autoimmune disease where antibodies are produced by the individual to attack and destroy their own melanocytes. Vitiligo depigmentation may be more or less important, and depigmented areas of varying sizes. At the other extreme, hair or hair that grow within the depigmented areas are also white. It usually appears before age 20 (half of those affected have been before that age). It is neither contagious nor suffering, but can lead to psychological distress because of its unsightly appearance.We do not know precisely the cause of vitiligo.

        Vitiligo results from the destruction of melanocytes (skin cells, giving the color "brown"), or of its depigmenting or white patch on the skin. Vitiligo is an acquired dermatosis characterized by the appearance of white patches and depigmented, increasing surface and number over time. This dermatosis is due to the disappearance of functional melanocytes and decreasing the rate of melanin in the epidermis. It can be disfiguring an aesthetic point of view and areas affected are more sensitive to sunburn. It affects 0.1 to 2% of the world population, with no predominance of sex or ethnicity. The etiology is unknown and many hypotheses do not explain the pathogenesis of all forms of the disease. Although there is no completely satisfactory solution to treat vitiligo currently, many options can lead to acceptable results in most patients.

How is the diagnosis of vitiligo?

       The diagnosis of vitiligo is clinical, ie established after careful consideration. There is no specific biological test. The review in light of Wood gives a better view of vitiligo spots but also to determine whether the defi cit melanoma is partial or total. Sometimes the use of a skin biopsy is useful to distinguish it from other lesions associated with abnormal skin color. It then shows a lack of melanin pigment and melanocytes in the lesional skin. In most cases, this biopsy is not necessary. Vitiligo should be distinguished from other acquired depigmentation such as psoriasis, eczema, discoid lupus, scleroderma and some forms of leprosy. Examination of the dermatologist, examination in light of Wood can make the diagnosis in most cases.

Vitiligo types

        There are two main types of vitiligo:

1. Affecting only one side of the body, generally along an innervation of the skin. It is quite common on the face to see what type of vitiligo.
2. Affecting both sides of the body, often symmetrically. It usually starts in the hands or face and can spread, usually in spurts.

There may be areas within the remaining pigmented patches of vitiligo, especially around the hair. This is explained by the persistence of melanocytes pilar. This is called vitiligo Spotted

Vitiligo treatment ... vitiligo cure

        There is no effective vitiligo treatment for all cases. The goal of treatment is to limit the size and number of patches of depigmentation. In children, doctors often use a strong preference and just protection against the sun and cover with clothing. By cosmetic camouflage. The application of cosmetics such as make-up specialist or self-tanning cream on the depigmented areas makes less apparent discoloration of the skin, without treating the disease. (Self-tanning creams do not require the presence of melanocytes to give the skin a tanned complexion.) Cosmetics are particularly useful for people who have vitiligo areas in periphery of the eyes, where the topical corticosteroids and UV rays are against inappropriate.

Vitiligo pictures

Repigmentation vitiligo treatments.

       The aim of these treatments is to stimulate the proliferation of melanocytes present in the skin. The dermatologists were able to obtain repigmentation in many cases, especially if treated early. The repigmentation can be achieved by two methods: the method by photochemotherapy PUVA or topical immunomodulators.

        Photochemotherapy with PUVA method (combination of psoralen and UVA) is to combine the exposure of the skin to UV rays to the (oral or topical application) of a substance called psoralen. Psoralen, ingested two to three hours before phototherapy, makes the skin more sensitive to ultraviolet rays. It would be a highly effective treatment (in 50 to 70% of cases), but there is less to treat vitiligo located on the feet or hands. The treatment requires a large attendance since it is conducted in several sessions (100 to 300) on a one to three times a week. However, after 40 to 50 sessions, you can see if the treatment will be effective. It can cause itching, pain and a burn like a sunburn. In the long term, it slightly increases the risk of cancer of the peau1. Against-indication. Photochemotherapy is against inappropriate for children under 12 years of age and pregnant or lactating.

        The excimer laser is used and acts on the same principle. It gives similar results but circumscribed lesions. Its advantage lies in the response time which is the shortest compared to other methods, but it is expensive vitiligo treatment.

Other vitiligo treatment methodes

• The photochemotherapy involves oral, substances that stimulate the formation of melanin by the action of light, and ultra violet A (UVA). It is less and less used because of its many side effects.
• The action of UVA light is reflected by a darkening of the skin. The importance of browning is variable depending on the individual. This effect is even more important that the concentration of psoralens in skin cells is high. This concentration is at its maximum on average two to four hours after taking oral psoralens and persists about eight hours.
• The local-photochemotherapy using psoralens directly on the skin and the sun. It is less used because it is constantly incidents or accidents phototoxic (due to light) and sometimes exacerbation of vitiligo. During phototherapy conducted under the supervision of a dermatologist, the risk of cancer is exceptional.
• The heliotherapy (use of solar radiation) was first used by the Egyptians 6000 years ago. It can be used successfully on a deficit vitiligos with melanoma incomplete. The protocol of short exposures will be defined by the dermatologist.
• Other photosensitizing agents such as a substance extracted from a fruit called Mediterranean Khela, khelline the substance chemically close to the photosensitizing psoralen, and phenylalanine (amino acid components of proteins) give comparable results but are not yet of use. Vitamin D or its derivative, calcipotriol, potentiate the effect of photochemotherapy, but various studies have led to conflicting results.
• The immunosuppressants and corticosteroids in topical application are shown mainly in vitiligos slightly extended. They work by decreasing the activity of the immune system, which has the effect of halting the loss of melanocytes. They must be applied once a day for several months. The results are faster than photochemotherapy with fewer side effects. Local effects of steroids should not be ignored. They can lead to thinning and fragile (atrophy) of the skin, prolonged local use.
• Tacrolimus is an immunosuppressant local. It neutralizes the action of lymphocytes, white blood cells responsible for immune response in vitiligo. He further action repigmentation of the skin especially valuable in areas exposed to the sun such as face and neck.
• By camouflage cosmetics, make-up special, may be considered for sensitive areas such as the edge of the eye where corticosteroid creams and phototherapy should not be used because of the risk of serious complications.
• Transplants of autologous melanocytes: melanocytes of the topic itself are taken from normally pigmented areas and grafted into depigmented areas. They may be performed only in cases of vitiligo narrow, stable, non-progressive, without Koebner phenomenon after failure of usual treatment in patients with normal healing without keloids. The graft may be used as appropriate, only melanocytes, sampled and re-zone or depigmented ultrathin skin grafts. These methods are very limited practice. They are emergency measures and aesthetic results, which depend on the type of vitiligo, are not always satisfactory because the obtained repigmentation is not always consistent. These results are even more interesting that the subject is young and it is a segmental vitiligo.
• The complete depigmentation is a technique that can be proposed to deal with some residual pigmented areas in the vitiligos widespread (universal). It generally requires highly irritating and possibly toxic which are reserved for this purpose . It is a challenge tive without the possibility of repigmentation later. Hypersensitivity to sunlight (photosensitivity), risks of sunburn and skin cancer must be understood and accepted by the patient. Topical immunomodulators may be prescribed for repigment small patches of vitiligo, such as corticosteroid creams or tacrolimus. These creams decreased the activity of the immune system (including autoimmune reaction), which has the effect of halting the destruction of melanocytes. They must be applied once a day for several months. The treatment with corticosteroids gets visible results more quickly than photochemotherapy and with less impact secondaires2 but is less stable than the latter term3 long. These creams are sometimes prescribed to children, with increased surveillance.

       New repigmentation treatments are being studied or are starting to be more commonly used, such as the use of UVB radiation spectrum narrow, with few side effects and appropriate to the child and wife enceinte2. Treatment of depigmentation. The objective here is depigmenting finally all of the skin to obtain a uniform appearance. This therapeutic option is to consider when vitiligo covers a large proportion of the body. Chemical solutions "whitening" are applied every day for over a year. However, half of those treated suffer side effects (redness and dry skin, burns, etc..), And once treatment is completed, the sun should be avoided if possible because the skin becomes very sensitive. In more serious cases, particularly when the hair and hair themselves are depigmented, skin grafts and transplantation of melanocytes can be proposed as a vitiligo surgical treatment.

Vitiligo Symptoms and Vitiligo Complications ... Vitiligo Symptoms explained

       Vitiligo is manifested by the appearance of white patches of irregular shape on the body or by various degrees of depigmentation. The loss of pigment is usually found first in the following areas:

1. Arms
2. Lip
3. Hands
4. Feet
5. Face

Other areas where white patches due to vitiligo may occur include:

1. Groin
2. Armpits
3. Nostrils
4. The navel
5. The genitals
6. Eyes

Melanin protects the skin against the effects of the sun. A lack of pigmentation in the skin increases the risk of sun sensitivity in affected areas. Vitiligo increases the risk of sunburn and skin cancer.